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Glomerular filtration rate and N-terminal pro-brain natriuretic peptide as predictors of cardiovascular mortality in vascular patients.
J Am Coll Cardiol. 2007 Jun 05; 49(22):2172-81.JACC

Abstract

OBJECTIVES

The purpose of this work was to assess the prognostic role of glomerular filtration rate (GFR) and NT-terminal pro-B-type natriuretic peptide (NT-proBNP) for mortality end points in the vascular population.

BACKGROUND

The GFR and NT-proBNP have been shown to predict mortality end points in free-living and limited vascular populations, independent of traditional risk factors. However, their prognostic power in an unrestricted vascular population is poorly understood.

METHODS

A total of 412 subjects from a vascular cohort with a history of either peripheral arterial disease (PAD) and/or other cardiovascular disease (CVD) were included in this prospective cohort analysis and followed for an average of 6.7 years. Outcome variables were all-cause mortality, ischemic heart disease (IHD) mortality, and any cardiovascular mortality. The prognostic roles of GFR and NT-proBNP levels were determined using multivariate survival analysis.

RESULTS

Higher GFR (per 10 ml/min/1.73 m2) was significantly protective for all-cause mortality (hazard ratio [HR] 0.81, p < 0.001), IHD mortality (HR 0.82, p = 0.008), and CVD mortality (HR 0.84, p = 0.005). Conversely, NT-proBNP was not a significant predictor of any mortality end point. The GFR showed the strongest association in subjects with a history of other CVD. Although NT-proBNP did not demonstrate a significant prognostic role in any of the subgroups, the data were suggestive for patients with PAD alone.

CONCLUSIONS

Glomerular filtration rate was a robust predictor of all-cause, IHD, and cardiovascular mortality in the vascular population, particularly in those with a history of other CVD, while NT-proBNP showed a suggestive association limited to the group with PAD only. These findings suggest that these markers must be selectively applied in the vascular population for greatest clinical utility.

Authors+Show Affiliations

University of California San Diego, San Diego, California 92093, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

17543637

Citation

Shadman, Ramin, et al. "Glomerular Filtration Rate and N-terminal Pro-brain Natriuretic Peptide as Predictors of Cardiovascular Mortality in Vascular Patients." Journal of the American College of Cardiology, vol. 49, no. 22, 2007, pp. 2172-81.
Shadman R, Allison MA, Criqui MH. Glomerular filtration rate and N-terminal pro-brain natriuretic peptide as predictors of cardiovascular mortality in vascular patients. J Am Coll Cardiol. 2007;49(22):2172-81.
Shadman, R., Allison, M. A., & Criqui, M. H. (2007). Glomerular filtration rate and N-terminal pro-brain natriuretic peptide as predictors of cardiovascular mortality in vascular patients. Journal of the American College of Cardiology, 49(22), 2172-81.
Shadman R, Allison MA, Criqui MH. Glomerular Filtration Rate and N-terminal Pro-brain Natriuretic Peptide as Predictors of Cardiovascular Mortality in Vascular Patients. J Am Coll Cardiol. 2007 Jun 5;49(22):2172-81. PubMed PMID: 17543637.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glomerular filtration rate and N-terminal pro-brain natriuretic peptide as predictors of cardiovascular mortality in vascular patients. AU - Shadman,Ramin, AU - Allison,Matthew A, AU - Criqui,Michael H, Y1 - 2007/05/18/ PY - 2006/10/10/received PY - 2007/02/01/revised PY - 2007/02/06/accepted PY - 2007/6/5/pubmed PY - 2007/7/6/medline PY - 2007/6/5/entrez SP - 2172 EP - 81 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 49 IS - 22 N2 - OBJECTIVES: The purpose of this work was to assess the prognostic role of glomerular filtration rate (GFR) and NT-terminal pro-B-type natriuretic peptide (NT-proBNP) for mortality end points in the vascular population. BACKGROUND: The GFR and NT-proBNP have been shown to predict mortality end points in free-living and limited vascular populations, independent of traditional risk factors. However, their prognostic power in an unrestricted vascular population is poorly understood. METHODS: A total of 412 subjects from a vascular cohort with a history of either peripheral arterial disease (PAD) and/or other cardiovascular disease (CVD) were included in this prospective cohort analysis and followed for an average of 6.7 years. Outcome variables were all-cause mortality, ischemic heart disease (IHD) mortality, and any cardiovascular mortality. The prognostic roles of GFR and NT-proBNP levels were determined using multivariate survival analysis. RESULTS: Higher GFR (per 10 ml/min/1.73 m2) was significantly protective for all-cause mortality (hazard ratio [HR] 0.81, p < 0.001), IHD mortality (HR 0.82, p = 0.008), and CVD mortality (HR 0.84, p = 0.005). Conversely, NT-proBNP was not a significant predictor of any mortality end point. The GFR showed the strongest association in subjects with a history of other CVD. Although NT-proBNP did not demonstrate a significant prognostic role in any of the subgroups, the data were suggestive for patients with PAD alone. CONCLUSIONS: Glomerular filtration rate was a robust predictor of all-cause, IHD, and cardiovascular mortality in the vascular population, particularly in those with a history of other CVD, while NT-proBNP showed a suggestive association limited to the group with PAD only. These findings suggest that these markers must be selectively applied in the vascular population for greatest clinical utility. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/17543637/Glomerular_filtration_rate_and_N_terminal_pro_brain_natriuretic_peptide_as_predictors_of_cardiovascular_mortality_in_vascular_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(07)00987-4 DB - PRIME DP - Unbound Medicine ER -